Individual
MARY L DAUBENMIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
25476 BUENA VISTA RD, ROCKBRIDGE, OH 43149-9554
(740) 407-2518
Mailing address
25476 BUENA VISTA RD, ROCKBRIDGE, OH 43149-9554
(740) 407-2518
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0330370
—
OH
05
—
3701495
—
OH
Enumeration date
12/15/2020
Last updated
12/15/2020
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